{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:50:37Z","timestamp":1786978237048,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002732","name":"AOSpine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction\/Aims<\/jats:title>\n \n Diagnosis of degenerative cervical myelopathy (\n DCM<\/jats:styled-content>\n ) is frequently delayed. A lack of awareness and standardized screening criteria have been identified as major contributors. The objective of this study was to conduct a survey of international experts to determine the value of various signs and symptoms in diagnosing patients with\n DCM<\/jats:styled-content>\n . This study forms part of a three\u2010step initiative that aims to develop pragmatic screening criteria for\n DCM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n An open voluntary English\u2010language Likert scale survey was disseminated among international networks of experts in\n DCM<\/jats:styled-content>\n . Respondents were asked to rank each sign or symptom on a scale of 0 (\n not important at all<\/jats:italic>\n ) to 10 (\n extremely important<\/jats:italic>\n ); a mean value of \u2265\u20096.5 was set a priori as the threshold to consider a feature as having significant diagnostic value.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fifteen symptoms and 12 signs were ranked as having significant diagnostic value. The most highly ranked symptoms are primarily related to abnormalities of the upper limb, hand function, and gait. The top\u2010rated signs included pathological reflexes as well as impairment of motor function, gait, and coordination. Features ranked as significant were largely consistent across professions, levels of experience, and continental regions.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n The integration of expert stakeholder opinion with evidence from existing literature strengthens the clinical framework for identifying key clinical features of\n DCM<\/jats:styled-content>\n . These 27 features will be discussed at an international consensus meeting to establish a standardized clinical screening toolkit that can be used by frontline healthcare professionals to detect patients with\n DCM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mus.70068","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T14:41:12Z","timestamp":1764772872000},"page":"260-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Healthcare Provider Perspectives of Various Signs and Symptoms for Diagnosing Degenerative Cervical Myelopathy: Results of an International, Multidisciplinary Survey"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0449-5786","authenticated-orcid":false,"given":"Lance A.","family":"Burn","sequence":"first","affiliation":[{"name":"Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanzil","family":"Rujeedawa","sequence":"additional","affiliation":[{"name":"Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Lalkhen","sequence":"additional","affiliation":[{"name":"The Manchester and Salford Pain Centre Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan R.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"MacDowall","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences Uppsala University Uppsala Sweden"},{"name":"Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5089-8280","authenticated-orcid":false,"given":"Brian K.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, International Collaboration on Repair Discoveries (ICORD) University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4396-4796","authenticated-orcid":false,"given":"Carl M.","family":"Zipser","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist University Hospital Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Treanor","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy & Neurosurgery Beaumont Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7104-122X","authenticated-orcid":false,"given":"David B.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, School of Health Sciences University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Martin\u2010Moore","sequence":"additional","affiliation":[{"name":"Myelopathy.org Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Guest","sequence":"additional","affiliation":[{"name":"Neurological Surgery University of Miami Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Harrop","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Milligan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2038-0018","authenticated-orcid":false,"given":"Julio C.","family":"Furlan","sequence":"additional","affiliation":[{"name":"KITE Research Institute and Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network Toronto Ontario Canada"},{"name":"Department of Medicine, Division of Physical Medicine and Rehabilitation University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Margetis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Icahn School of Medicine at Mount Sinai New York New York 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Neurosciences University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery and Spine Program, Department of Surgery University of Toronto Toronto Ontario Canada"},{"name":"Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W. 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